Price transparency is a critical element for ensuring not only a healthy revenue cycle, but also patient engagement and overall organizational success. With the spread of consumerism in healthcare, more patients are expecting pre-service estimates and a seamless billing and payment process. However there is one primary factor in that process that can be less than clear: insurance coverage.
With the expansion of Medicare has also come a rise in Medicare Advantage plan enrollment by American seniors. Older patients are attracted to these "replacement plans" due to savings on premiums and the convenience of one-stop shopping for coverage. However, misinformation and a lack of education on the details of these plans is causing headaches for enrollees and healthcare organization reimbursement departments alike.
It’s no secret that the healthcare reform is changing the way medical providers operate. Patient responsibility is higher than ever, and consumers are having a difficult time understanding their new policies. This leads to higher patient balances, which often go unpaid. In addition, with co-pays, deductibles and co-insurances on the rise, patients are beginning to shop around for care. In order to compete, the emphasis in medical practices must shift from volume to value.
Last week’s HFMA Maryland chapter event, The HealthCare “Three R’s”: Regulation – Reform – Reimbursement conference, shed light on the effects of the Affordable Care Act in Maryland, and how the local healthcare community is reacting to the reform.